STEROID THERAPY IN ENDOCRINE DISORDERS

Mine is perhaps the easiest of the subjects on today's program with which to deal. Administration of adrenal steroids to patients with endocrine disorders is almost invariably "replacement" therapy; and, if one adopts a simple philosophy that nature is almost always right, the problem becomes one of imitating nature as closely as one can. In other words, the effort is to provide the organism with the same quantity of steroid hormones which the adrenals could have and would have delivered had their mechanisms been intact. I shall develop my thesis along these lines and later perhaps point out some situations in which this philosophy may perhaps be inadequate or less than optimal.

There is excellent reason for believing that under normal conditions the adrenal glands secrete into the circulation approximately 25 mg. of hydrocortisone each 24 hours, and of aldosterone, the equivalent in desoxycorticosterone acetate of 1 to 2 mg.